286 research outputs found
Approcci innovativi per studi sui patogeni del cavo orale: modelli di studio in vitro ed ex vivo
No full textNegli ultimi anni, sono stati proposti nuovi composti/strumenti per mantenere la salute orale e/o per trattare diversi problemi dentali/parodontali. Come è noto, la carie dentale si pone tra le infezioni più diffuse ed una sua gestione impropria comporta lo sviluppo di malattie rilevanti ed eventualmente all'estrazione dell’elemento dentale. Una vasta letteratura documenta il ruolo patogenetico di diversi microorganismi che sono in grado di persistere nel cavo orale, in quanto capaci di organizzandosi come comunità microbica eterogenea (comprendente batteri, virus e funghi), adesa alle diverse superfici, strettamente racchiusa in una matrice polimerica di origine polisaccaridica. Tale comunità sessile, che se adesa ai denti è detta placca dentale, è notoriamente refrattaria non solo alle comuni procedure di pulizia con collutori e dentifrici/spazzolini, ma anche ai farmaci antimicrobici e alle difese immunitarie dell'ospite. Questo scenario si complica ulteriormente considerando che l’ampio uso di attacchi fissi o rimovibili nei trattamenti ortodontici espande la problematica e la conseguente sfida clinica, essendo tali dispositivi un ulteriore habitat utile per l'adesione microbica, la crescita e la formazione di biofilm. In misura simile, i pazienti con impianti dentali possono sviluppare localmente malattie legate alla produzione di biofilm impianto-associato, consentendo la progressione clinica verso quadri di perimucosite o perimplantite infettiva. Da qui, sorge la necessità di strumenti/composti innovativi per facilitare la rimozione di microrganismi potenzialmente patogeni e il mantenimento dell'omeostasi del cavo orale. Oltre ai patogeni orali più noti, tra cui il gruppo Streptococcus mutans e il "complesso rosso" dei bacilli anaerobi Gram-negativi, anche Candida albicans (C. albicans), Staphylococcus aureus (S. aureus) e Pseudomonas aeruginosa (P. aeruginosa) possono essere agenti eziologici di malattie orali. Il primo germe, spesso ospitato come commensale delle mucose sane, è il principale patogeno fungino coinvolto nella mucosite orale. Gli altri due sono patogeni molto subdoli, responsabili di malattie ad ampio spettro; considerati i loro numerosi fattori di virulenza e l’ampia farmaco-resistenza, S. aureus e P. aeruginosa sono ampiamente utilizzati per studi in vitro come preziosi prototipi di patogeni Gram-positivi e Gram-negativi. Lo scopo della presente tesi era di valutare in vitro ed ex vivo l'efficacia antimicrobica e antibiofilm di approcci innovativi contro i patogeni orali. Questa tesi ha fornito prove in vitro ed ex vivo sull'efficacia antimicrobica di composti nuovi e tradizionali per la cura e l’igiene del cavo orale, da cui possono derivare in prospettiva scelte più razionali e consapevoli. Ad esempio, un nuovo utilizzo del prodotto endodontico Cupral potrebbe essere proposto nelle pratiche di igiene quotidiana, così come potrebbe essere privilegiato il trattamento delle peri-implantiti con il sistema Bic-40, vista la sua particolare efficacia nella pulizia e nella decontaminazione di superfici lisce e ruvide in titanio, senza influire sulla vitalità delle cellule staminali dell’ospite. Inoltre, il nostro lavoro ha aggiunto nuove conoscenze sulle proprietà antimicrobiche di un composto naturale come la propoli e sui suoi possibili meccanismi d'azione, offrendo nuove opportunità nella ricerca di molecole antimicrobiche alternative. Infine, abbiamo dimostrato che il dentifricio e la gomma Biorepair Peribioma possono influenzare profondamente il comportamento dei microorganismi del cavo orale, a favore di condizioni utili al mantenimento dello stato di salute di questo distretto anatomico. Questo lavoro ha fornito nuove evidenze su come contrastare i patogeni, particolarmente se produttori di biofilm; facilitando il disegno di strategie mirate per la prevenzione e/o il trattamento delle infezioni dentali e orali associate al biofilm.During recent years, novel compounds/tools are being proposed to maintain oral health and/or to treat dental/periodontal problems. As well known, dental caries are among the most diffused infections and their improper management turns towards relevant disease(s) and eventually tooth extraction. Extensive literature documents the pathogenic role of certain microorganisms and their ability to persist in the oral cavity, as a complex microbial community, including bacteria, viruses and fungi, tightly enclosed in a polymeric matrix of polysaccharide origin. Such sessile community, and particularly dental plaque, the first deeply studied human-associated biofilm, is notoriously refractory not only to common cleaning procedures by mouthwashes and tooth-pastes/brushes, but also to antimicrobial drugs and host immune defenses. This scenario becomes further complicated considering that the widely diffused orthodontic treatments, with fixed or removal brackets, extend the clinical challenge, being such devices an additional good habitat for microbial adhesion, growth and biofilm formation. To a similar extent, patients with dental implants may locally develop biofilm-related diseases, allowing clinical progression toward pathogen-related peri-mucositis or peri-implantitis. From here, the need arises for innovative tools/compounds to facilitate microbial removal and maintenance of oral cavity homeostasis. Besides the most investigated oral pathogens, including Streptococcus mutans-group and the “red complex” Gram-negative anaerobe bacilli, also Candida albicans (C. albicans), Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) may occur as causative agent of oral diseases. The first, often harbored as commensal of healthy mucosae, is the main fungal pathogen involved in oral mucositis. The latter two are subtle pathogens, responsible of wide-spectrum diseases; they are being extensively used for in vitro studies, because of their numerous virulence factors and wide-spectrum antimicrobial resistance. The aim of the present thesis was to evaluate in vitro and ex vivo, the antimicrobial and antibiofilm efficacy of innovative approaches against oral pathogens. Our data provided in vitro and ex vivo evidence on the antimicrobial efficacy of several dental-care compounds. A novel use of the endodontic product Cupral could be proposed in daily hygiene practices. The Bic-40 treatment was shown as the best approach in cleaning smooth and rough titanium surfaces (without altering their properties); importantly, its device-decontamination efficacy did not affect the biological properties of reparative stem cells. Furthermore, our work added new insights on the anti-microbial properties of a natural compound, such as propolis, and on its possible mechanisms of action. At last, we showed that the Biorepair Peribioma toothpaste and gum deeply affected oral microorganisms’ behavior, drastically impairing their ability to contaminate and produce plaque onto orthodontic devices; interestingly, replacement by beneficial microorganisms was observed. The overall take-home message from this research is that basic science may greatly increase our knowledge on how to counteract biofilm-producing pathogens; in turn, this will facilitate prevention and/or treatment of dental and oral biofilm-associated infections, making a huge difference in terms of health promotion
Effects of Cupral® on the formation and persistence of microbial biofilms in vitro
No full textIntroduction: endodontic biofilm is a microbial community, enclosed in a polymeric matrix of polysaccharide origin where are frequently found pathogenic microorganisms, such as Gram+, Gram- and opportunistic fungi, belonging to Candida spp, responsible for several endodontic pathologies. As clinical importance is the fact that biofilm is extremely resistant to common intra-canal irrigants, antimicrobial drugs and host immune defenses. The aim of this in vitro study was to evaluate the efficacy of Cupral® on planktonic forms of some pathogens, as well as to assess its ability to prevent and affect the formation/persistence of microbial biofilms.
Materials and Methods: ATCC strains of S. aureus, P. aeruginosa and C. albicans were exposed to various concentrations of Cupral® (an antiseptic compound based on calcium and copper hydroxide, used in endodoncy) to investigate its antimicrobial efficacy. This activity has been evaluated in terms of microbial growth and cellular doubling time (optical density, colony forming units and doubling time assays), inhibition/persistence (crystal violet staining), viability of microbial cells embedded in the biofilms (live/dead stain) and pyoverdine production (fluorimetric assay). Finally, the morphology of Cupral®-treated biofilms was investigated by optical/confocal microscopy analysis.
Results: the addition of Cupral® to microbial cultures, influences, in a significantly and dose-dependent manner, the doubling time and growth of microbial cultures. Cupral® antimicrobial activity was also assessed on biofilms formation and persistence with meaningful decreases of residual biomass (observed reductions of 47-94% for S. aureus, 28-95% for P. aeruginosa and 27-75 % for C. albicans). Cupral®-treated biofilms analyzed by optical and confocal microscopy revealed loss of typical sessile structure, with few scattered microbial cells and a reduced thickness. Finally, the addition of Cupral® reduced both the number of embedded alive cells in the biofilms and the levels of pyoverdine in the culture supernatants.
Discussion and Conclusions: this pilot in vitro study provided the first evidences on Cupral® efficacy against microbial biofilms. The wide range of action (vs Gram+, Gram- and fungi) of Cupral® strongly suggests its use as compound in the prevention and treatment of main oral biofilm-associated infections
Propolis affects Pseudomonas aeruginosa Growth, Biofilm Formation, Phenazines and eDNA Release: Potential Involvement of Polyphenols
No full textPseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen responsible for a wide range of clinical conditions, from mild infections to life-threatening nosocomial biofilm-associated diseases, which are particularly severe in susceptible individuals. The aim of this in vitro study was to assess the effects of an Albanian propolis on several virulence-related factors of P. aeruginosa, such as growth ability, biofilm formation, extracellular DNA (eDNA) release and phenazine production. To this end, propolis was processed using three different solvents and the extracted polyphenolic compounds were identified by means of High Performance Liquid Chromatography coupled to–Mass spectrometry (HPLC-MS) analysis. As assessed by a bioluminescence-based assay, among the three propolis extracts, the ethanol (EtOH) extract was the most effective in inhibiting both microbial growth and biofilm formation, followed by propylene glycol (PG) and polyethylene glycol 400 (PEG 400) propolis extracts. Also, Pseudomonas exposure to propolis EtOH extract caused a decrease in eDNA release and phenazine production. Interestingly, caffeic acid phenethyl ester (CAPE) and quercetin decreased upon propolis EtOH extract exposure to bacteria. Overall, our data add new insights on the anti-microbial properties of a natural compound, such as propolis against P. aeruginosa. The potential implications of these findings will be discussed
The influence of orthopedic rapid maxillary expansion on the deviation of the nasal septum
No full textNasal septal deviation (NSD) is one of the most common abnormalities impacting the maxillofacial development of children. Herein, we investigated the impact of orthopedic rapid maxillary expansion (RME) on the nasomaxillary complex and NSD in pediatric patients. The study sample consisted of a total of 40 patients divided into two groups. The experimental group included 26 patients (13 females and 13 males) with skeletal maxillary transversal constriction and NSD greater than 1 mm, while the control group comprised 14 patients (6 females and 8 males) with skeletal maxillary transversal constriction but no NSD. All the patients were treated for approximately 15 days with the tooth-tissue born RME device. The activation procedure was to turn the transversal Hyrax screw a quarter turn, twice a day. After that, the device was left in place for a period of five months to facilitate passive retention. Radiographic analysis was performed on posteroanterior (PA) cephalometric radiographs taken at pre-expansion (T1) and post-expansion (T2). The data were evaluated using the Mann-Whitney U and Wilcoxon Sign tests. The experimental group showed a statistically significant decrease (p < 0.05) in the distance from the axis of symmetry to middle of nasal septum (SNM-mid) and to inferior part of the nasal septum (SNI-mid) measurements, indicating a reduction in NSD. Additionally, both experimental and control groups showed a statistically significant increase (p < 0.05) in maxillofacial measurements, including the distance between the nose length (X-SNM and SNM-SNAC), width of the nasal cavity (Pir L-R), basal maxillary width (Mx L-R), vestibular cuspid of upper first molars (CVM + L-R) and lower first molars (CVM-L-R). Based on the study findings, RME was considered effective in achieving craniofacial improvement in pediatric patients with NSD, which positively impacted their healthy growth and development. The improvement in the nasomaxillary complex was similar between genders
Occlusal Splints in Athletes: A Useful Appliance to Prevent Dental and Temporomandibular Joint Traumas
No full textBackground: Rugby is a fast-paced and physical contact sport which has gained popularity across the globe. Injuries are common, with research indicating that the most frequent injuries sustained during rugby match play involve the head and face. Using mouthguards is strongly recommended to reduce the risk of head and facial injuries; Methods: PubMed, Web of Science and Lilacs were systematically searched until 31/01/2023. In addition, a manual search was performed using the bibliography of selected articles and a Google Scholar search. Articles concerning athletes and the mouth guard were considered as inclusion criteria. It was completed, and the articles were read to assess theireligibility; Results: 104 articles were selected. Specifically, 84 articles were found in PubMed, two from Lilacs and 18 from Web of Science. Clinical trials were selected as inclusion criteria. Therefore, three papers that met the inclusion criteria were selected; all the selected studies had and showed the possible influence of mouthguards and rugby athletes; Conclusions: Also, its most advantageous feature is the customized design that follows the correct anatomy of the mouth cavity. If MG use is to increase, more work must be done to improve their comfort. Although athletes will receive silicone rubber mouthguards, scientific advancements in silicone materials are required to increase the mouthguards’ stability and hardness for use in sports
Antibacterial Effects of MicroRepair®BIOMA-Based Toothpaste and Chewing Gum on Orthodontic Elastics Contaminated In Vitro with Saliva from Healthy Donors: A Pilot Study
No full textSeveral new products with innovative formulations are being proposed to facilitate oral care. Here, we evaluated the effects of a commercially available product, a toothpaste and chewing gum named Biorepair Peribioma, on oral microorganisms of healthy subjects. Saliva from six volunteers was collected during 20 min of mastication of a traditional gum (gum A) and the Biorepair Peribioma gum (gum P). Orthodontic elastics (OE) were in vitro contaminated with salivary samples, both A and P, and subsequently exposed or not to a Biorepair Peribioma toothpaste-conditioned supernatant (Tp-SUP). The salivary samples were tested for initial microbial load; hence, the contaminated OE were assessed for microbial growth, adhesion, biofilm formation and persistence; moreover, species identification was assessed. We found that the salivary samples A and P had similar microbial load; upon contamination, microbial adhesion onto the OE was detected to a lower extent when using saliva P with respect to saliva A. Microbial growth and biofilm formation, assessed at 24 h, remained at lower levels in OE exposed to saliva P, compared to saliva A. This difference between salivary samples A and P was confirmed when measuring biofilm persistence (48 h), while it was lost in terms of microbial re-growth (48 h). The Tp-SUP treatment drastically affected microbial load at 24 h and strongly impaired biofilm formation/persistence, in OE exposed to both salivary samples A and P. Finally, such treatment resulted in consistent overgrowth of Lactobacilli, bacterial species originally present both in the Biorepair Peribioma toothpaste and gum. In conclusion, by an in vitro pilot study, we show that the Biorepair Peribioma toothpaste and gum deeply affect oral microorganisms’ behavior, drastically impairing their ability to contaminate and produce plaque onto orthodontic devices
Cigarette smoke and tobacco heating aerosol on the aging of clear aligners
No full textBACKGROUND: The treatments with clear aligners (CA) showed an exponential higher percentage in the last years being almost invisible with major patient acceptability and a resulting improvement in quality of life. CA are composed of thermoplastic polyurethane not inert but subjected to changes due to heating and humidity, chewing forces, and prolonged exposure to enzymes in saliva in the oral cavity and external factors. Cigarette smoke (CS) and the aerosol produced by tobacco products with reduced health risks may be considered among the external factors affecting CA. The purpose of this study was the assessment of optical properties (absorbance and transmittance) and roughness of CA after in vitro aging due to exposition to CS and THS2.2, compared to controls. The secondary objective will be the investigation of CS and THS2.2 effects on resin composite inside aligners used for attachments during treatment with CA. METHODS: A total number of 60 CA units will be used and equally divided in three different groups (20 in each): CS group exposed to reference cigarettes smoking, THS2.2 group exposed to aerosol from 20 heat-not-burn sticks, and control group, CG to pure air only. The aligners will present ten introflection for the attachments on the anterior part. In accordance with ISO standard 3402, 3R4F cigarettes and THS2.2 tobacco sticks must undergo conditioning for a minimum of 48 hours and a maximum of 21 days at a temperature of 22 +/- 1 degrees C and a relative humidity of 60 +/- 3%. RESULTS: Using spectrophotometry, the optical characteristics (absorbance and transmittance) of each aligner will be evaluated after aging (Jasco UV-vis V630PC, Tokyo, Japan). Each aligner will be cut with a rotating saw from canine to canine prior to the measurements in order to lop off the lingual region and displaying the labial barrier. The absorbance and transmittance measurements will be collected and statistically analyzed with a significance of P<0.05. CONCLUSIONS: Surface roughness of the aligners and attachments inside them will be assessed by 3D scanning microscopy (Infinite Focus G4h). Color of resin composite will be assessed using the (CIE Lab) Commission Internationale de l'Eclairage L*a*b* color space by means of Olympus CrystalEyef dental spectrophotometer. Clinicians should advise patients to refrain from smoking and drinking coffee or tea while wearing aligners for two reasons: first, the color change is unacceptably noticeable when wearing aligners, and second, the material's chemical composition may be slightly altered, which could affect the intended dental movements
The relationship between pregnancy and temporomandibular disorder (TMD) through diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: a case-control cross-sectional study
No full textIntroductionThis study focuses on temporomandibular disorders (TMDs), which affect the temporomandibular joint and related muscles and have multiple causes. Recent studies have examined the connection between menstrual cycles, estrogen levels, and TMDs, but results are inconsistent, highlighting the need for more research. The aim is to explore the prevalence of TMDs in pregnant women and consider how hormonal changes during pregnancy might influence these disorders.MethodsIn this cross-sectional case-control study, we compared 32 pregnant women with 35 non-pregnant women. We evaluated several TMD-related factors such as pain levels, chronic pain classification, scores on the Jaw Functional Limitation Scale-20 and Oral Behaviors Checklist, and psychological health. We used various statistical methods including descriptive statistics, chi-square tests, linear regression, and adjustments for multiple comparisons to analyze the data.ResultsPregnant women showed different pain perceptions, generally reporting less pain and lower severity. Nonetheless, these differences were not uniform across all TMD-related measures. Linear regression did not find a consistent link between pregnancy and TMD scores, except for chronic pain grade, which was not significant after adjusting for multiple comparisons. There was a significant relationship between depression and TMD severity, emphasizing the need to consider mental health in TMD evaluations.DiscussionThe findings suggest that pregnancy is neither a risk nor a protective factor for TMD. Differences in pain perception, functional status, and psychological health were observed in pregnant women but were not consistent for all TMD-related aspects. The role of estrogen in TMJ health and TMD risk is complex and requires further study. The research highlights the necessity of including mental health, especially depression, in TMD assessments. More comprehensive research with larger sample sizes is essential to better understand the connections between pregnancy, TMD, and hormones, aiming to improve TMD management in pregnant women and others
Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study
No full textBackground: The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.Methods: This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.Results: The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).Conclusions: Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems
Photographic analysis of orofacial soft tissue alterations related to rapid maxillary expansion in pediatric patients
No full textMaxillary transverse deficiency is widely recognized as one of the most common skeletal issues in orthodontics, and rapid maxillary expansion (RME) is commonly employed as a treatment method. This study aimed to investigate the impact of RME on the soft tissues of the orofacial region in pediatric patients. The study included two groups: an experimental group comprising 30 patients (16 females and 14 males) with maxillary skeletal transverse deficiency who required rapid maxillary expansion (RME), and a control group consisting of patients (10 females and 10 males) who did not require RME or orthodontic treatment. Frontal and profile photographs were taken before and after RME for both groups. Frontal photographs were used to obtain 12 linear measurements, while profile photographs were used to perform 2 linear and 2 angular measurements using the protractor and pixel ruler software. Burstone-Legan, Steiner and Rickett's analyses were performed to determine the locations of the upper and lower lips. Student t-test, paired samples t-test and Mann-Whitney U test were used to evaluate the data. In the experimental group, there was a statistically significant increase in nose width and intercommissural distance at the end of the treatment (p < 0.05). Similarly, both the experimental and control groups showed a statistically significant increase in the dorsum of nose length at T2 compared to the initial measurement (p < 0.05). Furthermore, the male participants in the experimental group exhibited a statistically significantly higher increase in nose length and dorsum of the nose during the T1 and T2 periods compared to the female participants in the experimental group (p < 0.05). RME may lead to changes in soft tissues in pediatric patients and was observed to be gender-specific. However, these changes were not clinically noticeable, and long-term follow-up studies are needed to determine the long-term effects of these changes
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